Tuesday, July 13, 2010

Reflection from a Tuesday: Giving Your All and Getting Your All

"You cannot have it all."

That's what this senior female faculty physician said to my colleague-friend, Tracey H., amidst the beeping IV pumps and background hustle bustle of the ICU one day. Tracey was a new medical faculty member at her institution struggling with what many of us struggle with: figuring out how to effectively love on your husband and seamlessly raise up your children all while simultaneously saving the world as a clinician-educator/clinician-investigator/clinician-leader. Oh, and figuring out how to do these things while being happy at the same time.

So that was the advice. It wasn't, "Girl, you can do this" or "Chile, you can do that." It was this simple truth, as mundane as it was cutting edge. "You cannot have it all."

That was the first time I'd heard someone say this. The second and only other time I heard these words hit me even harder than the first. I'd slipped into one of these "Women in Medicine" panel discussions at the ACP National Meeting a few years back, and this really wise looking woman grabbed the microphone sitting in front of her with her right hand to make sure we heard her clearly. A room full of earnest, young, early career female clinical faculty members sat with baited breath. We'd already heard that we needed to speak up for ourselves. That we should not be afraid to take on big tasks with the big boys. And to not fear a confrontation, but to always lace all interactions tightly with insurmountable poise and professionalism. This is how we'd get where they were. Chairpersons of Departments, Deans of Medical Schools, nationally recognized researchers and educators, well-respected Division Directors, and all-around bad-asses.

That's when this Jedi Master perched her scarlet reading glasses on the tip of her nose and tucked her graying hair behind her ears, cleared her throat and said,

"My advice? Work hard, and learn to be an effective leader. If you do that you can achieve anything. But know this: It comes at a cost. You cannot have it all. You cannot be on the vertical quest for Department Chair and make all of the soccer games at the same time. Something has to give. So, my advice? Decide what you want. And always know that the pinnacles of success in medicine comes at a personal cost--especially for women--so never trick yourself into thinking otherwise. Trust me, I know. You cannot have it all."

Wow. Everything I heard after that sounded like garbled background noise. I'd never seen or heard a woman care so little about saying what was popular as this senior faculty member. She broke it all the way down. Perhaps I felt so convicted by her statement because, like my friend Tracey H., I was juggling life with a husband and two small children with climbing up the clinician educator ladder. I'd often ask myself, "How can I possibly publish 4 papers per year, and teach, and write a book chapter without interrupting my family life? How? How can I reach my full potential professionally without feeling like a failure in my personal life, or vice versa?"

I'd never known even part of the answer until that day. This was the start of me achieving a new level of comfort in my personal and professional lives, all from five simple words.

"You cannot have it all."

Genius. Well, the truth is that many of the women there did not find it so genius. They made passive aggressive comments that negated what, in my opinion, had been the most profound thing I'd heard in a long time. They didn't like that word 'cannot.' But, me? I thought it was genius. Or as my friend, Tracey H., said about the woman who said the same thing to her that day in the ICU, "It was more than genius. It was dope." Yeah, dope.

They had these microphone stands in the aisles for people to get up and ask questions or make comments to the panelists. I think the majority of the women there had written off my new guru, directing all of their words to others on the panel. The ones who rah-rah-rahed and sis-boom-bahed them into believing that 36 hours could be jammed into 24, and that, forget what that eccentric old party-pooper said, you can so have it all. But me? I wasn't buying it. I stood squarely at the end of that line, inching my way up to the microphone to get more clarity on the gospel that had indeed reached me, if no one else.

"Hi. My name is Kimberly Manning and I'm an Assistant Professor in Atlanta, Georgia. My question is for Dr. (I still can't recall her name.)" She leaned into the mike again, her red readers still at the tip of her nose. "I was hoping you could give me more clarity on what you said. You said, 'You cannot have it all.' Does that mean not strive as hard? Say 'no' more often?"

She smiled and pulled the microphone down again. "Dr. Manning, thank you for your question," she started, "No. You should strive. But here's the thing: you have to redefine what it means to be successful. That is a very personal definition. For me, it is helping decorate my son's dorm room at Yale. Another time it's sitting here on this panel answering your question. Dr. Manning, the minute I realized that I could not have it all was the moment discovered that I'd had it all from the start."

"So in other words, you can have it all," I said, taking in every drop of her sage advice. I watched her carefully; I didn't want to miss a thing.

She raised one eyebrow and leaned her face into her propped up index finger. With a half-smile she continued, "You can have your all. Just not yours and everyone else's at the same time. Your all and someone else's all may be completely different. You got me?" I SO got you, Jedi Master.

This turned out to be one of the most memorable "Karate Kid/Mr. Miyagi moments" that I've ever had in my career. I felt like an enormous weight was lifted off of my shoulders. "I can have my all," I whispered to myself. "Just not everyone else's at the same time."

Me and kids enjoying the sunset on the Potomac, Independence Day 2010

Today I am reflecting on what it means to have it all. Or better yet, what it means to have my all, and how I define success. My definition includes a deep and meaningful relationship with my husband, time to be physically and emotionally present to my children, family and friends, and professional growth that pushes me to my personal best but doesn't impinge upon the former two. This is my all. And now that I know what it is, I know that I can have it all indeed.

Glimpses of my all:

With Isaiah at the Georgia Aquarium 2008

Isaiah, Christmas holidays 2009

Me and Zachary on the way to the Pentagon

Daddy and Harry with the boys, June 2010

Mommy with the boys, Mother's Day 2009

Harry and me, wedding anniversary May 1, 2010

Mommy and Zachy making Arthur character cookieswith my best friend, Lisa, May 2010 (expecting her first baby, yay!)

with nearly all of my student advisees (potluck at my place 2009) little sis/bff, Darlene, at Farmer's Market in L.A.

Very sage advice. I don't have kids yet, but I have a family, a husband, friends, an elderly grandmother who requires a daily visit (the whole family tries to split it up and I try to do my part), and then on the other hand I have my own work. I think because I'm essentially self-employed, I always have a difficult time setting appropriate boundaries with my own time and deciding where I should be investing myself when. This was a great reminder about what really matters.

It struck me as I was reading this--I've had some wonderful doctors (and LOVE my current physician) and have always been enormously grateful for what various healthcare professionals have done for me and friends/family members of mine. But I'd never say that any one of those doctors/nurses have affected me more than, say, my mother has, you know? And, as a writer, the same is true about writing--so many pieces of literature have touched and even changed me, and done the same for society, and yet no book I'll ever read will have a greater impact on me than my mom, or dad, or brother, husband, etc.

Not that medical or literary or other career contributions aren't absolutely invaluable to society and to individuals, but a good reminder to me about perspective, about the places where I've been given huge responsibility in another's life (even more so when I have kids, I'm sure!) and where the weight of what I do and give is so huge. What I do as a wife/daughter/friend/granddaughter/sister/mom (hopefully!) will ultimately be more meaningful than what I do as a writer.

Always a challenge to find that balance, though. Thank you for this post.

Sniffle sniffity sniff! I really love this one. It even means a lot to this single gal with no kids. I have such a full life with family & friends, still leaving room for more. I know I can have MY all, and it doesn't have to be what anyone else thinks it should be. Love you oodles, Miz.

"If you dance to the music, you have to pay to the piper". I remember many of our discussions as you traveled along your journey. "I think that I want of be double-boarded" "What's that?" "You know, boarded in both pediatrics and general medicine". "How do you do that?" "Well, it basically takes and extra year" " Oh! OK sounds good to me"..."I've been selected to be chief resident!" "What does that mean and does it mean you will go out and get paid like a full doctor?" "Well, no but it will look really good on my resume'". "Sounds good to me". "I'm thinking about being a teaching doctor rather than going into private practice or something like that". " Well from what I know about the education field, the money will be less, but if that's what you want to do then go for it". "I decided to leave Cleveland and go to Atlanta and work at Emory". "Cool, you'll be there with the rest of the gang". "How much can I afford to pay for a car and a house/condo?". "Well, let's run some numbers". "How much will you be bringing home, etc,etc...?" We'll this is what it looks like you can comfortably afford". Tears running down your face.. "What's wrong?" "sniffle, sniffle" "I've been in school for 12 years and I can't afford to buy the house and car the I really want?" "Remember all of those discussions we had along the way?" "Yeah.. sniffle, sniffle" , "Each of those decisions had financial ramifications and you knew basically what they were as you made the decisions", "Yeah", "You were dancing to the music, now the piper must be paid" Another way of saying "You Can't have it all!!!" So what your Guru told you was definitely correct and it seems that you now understand the you must sit out some of those songs that you would really like to boogie to.

Did Bogey and Bacall really have it all? Maybe they had "Their all" huh?

Just after I left a comment on one of your posts earlier today, a friend sent me a link to this post after she had read my thoughts on "balance". What a coincidence! And it is so so SO encouraging to hear another mother in medicine process through this acceptance and liberation of knowing you can't have it all, but you can have what you truly care about. The more I talk to other physicians, it's striking how much we incorporate other people's definition of "having it all" into our own. In some ways, I think it's a mindset that is ingrained over time during the years of medical school and residency. I am glad to hear you've found your happy place and can recognize it! It is thoroughly refreshing to face the realities of our limitations and find peace in our own individual definitions of success. It is also liberating to know that the definition of success may even, to an outsider, appear to be marked by many failures.

Welcome to Atlanta.

"Becoming is better than being." - Carol Dweck

Who me? I'm just glad to be here.

Honestly? I write this blog to share the human aspects of medicine + teaching + work/life balance with others and myself -- and to honor the public hospital and her patients--but never at the expense of patient privacy or dignity.
Thanks for stopping by! :)

What's the point?

"One writes out of one thing only--one's own experience. Everything depends of how relentlessly one forces from this experience the last drop, sweet or bitter, it can possibly give."

~ James Baldwin (1924 - 1987)

"Do it for the story." ~ Antoinette Nguyen, MD, MPH

Details, names, time frames, etc. are always changed to protect anonymity. This may or may not be an amalgamation of true,quasi-true, or completely fictional events. But the lessons? They are always real and never, ever fictional. Got that?